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The next step is normally a trach, which takes the place of the ETT on the ventilator, and is easier on the trachea and helps to save the vocal cords. If a patient can not be weaned from the vent, then this is the next step, and makes it easier to transition the Pt to a rehab or home. Trachs do not have to permanent, if the Pt improves, it can be removed down the road. Good luck with this. At our hospital we sometimes give what we call an "extubation trial" for Pts we are not sure can be removed from the vent.. some do great, and some need to be reintubated. Normally after 2 fails, we go for the trach,
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